Hernia and abdominal wall: lipoma of the cord: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

General Surgery · Hernia and abdominal wall: lipoma of the cord

Sample item

During open repair of a right indirect inguinal hernia, the sac is dissected and ligated, but a lobulated mass of fat remains lying along the spermatic cord structures. What should the surgeon do?

AExcise the fat from the cordBLeave it, since it is harmlessCTake a biopsy only and closeDPush it back through the deep ring with the sac

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Excise the fat from the cord

A lipoma of the cord is extraperitoneal fat that follows the cord, often accompanying an indirect sac. Left in place it keeps a palpable lump and is a common reason for apparent early recurrence, so it is excised with the sac dissection. Fat lying inside the sac is a different matter.

Option by option

A. Excise the fat from the cord (correct)
Correct. Excision removes the persistent lump that would otherwise be mistaken for recurrence.
B. Leave it, since it is harmless
Leaving it behind keeps a palpable cord swelling after repair and causes concern about recurrence.
C. Take a biopsy only and close
Biopsy alone leaves the mass in situ and a benign fatty lump needs no sampling.
D. Push it back through the deep ring with the sac
Pushing it back through the deep ring does not remove it, and it can re-emerge along the cord.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Excise the fat from the cord. A lipoma of the cord is extraperitoneal fat that follows the cord, often accompanying an indirect sac.

Why is "Leave it, since it is harmless" not the answer?

Leaving it behind keeps a palpable cord swelling after repair and causes concern about recurrence.

Why is "Take a biopsy only and close" not the answer?

Biopsy alone leaves the mass in situ and a benign fatty lump needs no sampling.

Why is "Push it back through the deep ring with the sac" not the answer?

Pushing it back through the deep ring does not remove it, and it can re-emerge along the cord.

What concept does this question test?

It tests Hernia and abdominal wall: lipoma of the cord in General Surgery. Left in place it keeps a palpable lump and is a common reason for apparent early recurrence, so it is excised with the sac dissection. Fat lying inside the sac is a different matter.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hernia and abdominal wall: lipoma of the cord?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.